|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$738.48
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.08 |
| Max. Negotiated Rate |
$664.63 |
| Rate for Payer: Aetna Commercial |
$627.71
|
| Rate for Payer: Aetna Medicare |
$192.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.78
|
| Rate for Payer: BCBS Complete |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$184.62
|
| Rate for Payer: BCBS Trust/PPO |
$607.10
|
| Rate for Payer: BCN Commercial |
$574.17
|
| Rate for Payer: BCN Medicare Advantage |
$184.62
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cofinity Commercial |
$635.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.62
|
| Rate for Payer: Healthscope Commercial |
$664.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.86
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.85
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.71
|
| Rate for Payer: Nomi Health Commercial |
$605.55
|
| Rate for Payer: PACE Senior Care Partners |
$175.39
|
| Rate for Payer: PACE SWMI |
$184.62
|
| Rate for Payer: PHP Commercial |
$627.71
|
| Rate for Payer: PHP Medicare Advantage |
$184.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.01
|
| Rate for Payer: Priority Health HMO/PPO |
$642.48
|
| Rate for Payer: Priority Health Medicare |
$186.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.78
|
| Rate for Payer: Railroad Medicare Medicare |
$184.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.86
|
| Rate for Payer: UHC Core |
$616.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.62
|
| Rate for Payer: UHC Exchange |
$184.62
|
| Rate for Payer: UHC Medicare Advantage |
$184.62
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$184.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.86
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$738.48
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.01 |
| Max. Negotiated Rate |
$664.63 |
| Rate for Payer: Aetna Commercial |
$627.71
|
| Rate for Payer: BCBS Trust/PPO |
$602.82
|
| Rate for Payer: BCN Commercial |
$570.70
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cofinity Commercial |
$635.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.78
|
| Rate for Payer: Healthscope Commercial |
$664.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.71
|
| Rate for Payer: Nomi Health Commercial |
$605.55
|
| Rate for Payer: PHP Commercial |
$627.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.01
|
| Rate for Payer: Priority Health HMO/PPO |
$642.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.86
|
| Rate for Payer: UHC Core |
$616.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.86
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$116.88
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$75.97 |
| Max. Negotiated Rate |
$105.19 |
| Rate for Payer: Aetna Commercial |
$99.35
|
| Rate for Payer: BCBS Trust/PPO |
$95.41
|
| Rate for Payer: BCN Commercial |
$90.32
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cofinity Commercial |
$100.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.50
|
| Rate for Payer: Healthscope Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.35
|
| Rate for Payer: Nomi Health Commercial |
$95.84
|
| Rate for Payer: PHP Commercial |
$99.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$101.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.85
|
| Rate for Payer: UHC Core |
$97.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.66
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$116.88
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$105.19 |
| Rate for Payer: Aetna Commercial |
$99.35
|
| Rate for Payer: Aetna Medicare |
$30.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.52
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$29.22
|
| Rate for Payer: BCBS Trust/PPO |
$96.09
|
| Rate for Payer: BCN Commercial |
$90.87
|
| Rate for Payer: BCN Medicare Advantage |
$29.22
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cofinity Commercial |
$100.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.22
|
| Rate for Payer: Healthscope Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.35
|
| Rate for Payer: Nomi Health Commercial |
$95.84
|
| Rate for Payer: PACE Senior Care Partners |
$27.76
|
| Rate for Payer: PACE SWMI |
$29.22
|
| Rate for Payer: PHP Commercial |
$99.35
|
| Rate for Payer: PHP Medicare Advantage |
$29.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$101.69
|
| Rate for Payer: Priority Health Medicare |
$29.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.31
|
| Rate for Payer: Railroad Medicare Medicare |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.85
|
| Rate for Payer: UHC Core |
$97.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Medicare Advantage |
$29.22
|
| Rate for Payer: VA VA |
$29.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.66
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$456.96
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.53 |
| Max. Negotiated Rate |
$411.26 |
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: Aetna Medicare |
$118.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.80
|
| Rate for Payer: BCBS Complete |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$375.67
|
| Rate for Payer: BCN Commercial |
$355.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$411.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.72
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: Nomi Health Commercial |
$374.71
|
| Rate for Payer: PACE Senior Care Partners |
$108.53
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.02
|
| Rate for Payer: Priority Health HMO/PPO |
$397.56
|
| Rate for Payer: Priority Health Medicare |
$115.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.16
|
| Rate for Payer: Railroad Medicare Medicare |
$114.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.12
|
| Rate for Payer: UHC Core |
$381.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.24
|
| Rate for Payer: UHC Exchange |
$114.24
|
| Rate for Payer: UHC Medicare Advantage |
$114.24
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$114.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.72
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$456.96
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$297.02 |
| Max. Negotiated Rate |
$411.26 |
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: BCBS Trust/PPO |
$373.02
|
| Rate for Payer: BCN Commercial |
$353.14
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.57
|
| Rate for Payer: Healthscope Commercial |
$411.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: Nomi Health Commercial |
$374.71
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.02
|
| Rate for Payer: Priority Health HMO/PPO |
$397.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.12
|
| Rate for Payer: UHC Core |
$381.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.72
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,483.45
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,439.82 |
| Max. Negotiated Rate |
$13,035.10 |
| Rate for Payer: Aetna Commercial |
$12,310.93
|
| Rate for Payer: Aetna Medicare |
$3,765.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,526.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,526.08
|
| Rate for Payer: BCBS Complete |
$4,982.55
|
| Rate for Payer: BCBS MAPPO |
$3,620.86
|
| Rate for Payer: BCBS Trust/PPO |
$11,906.84
|
| Rate for Payer: BCN Commercial |
$11,260.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,620.86
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cofinity Commercial |
$12,455.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,586.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,620.86
|
| Rate for Payer: Healthscope Commercial |
$13,035.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,862.59
|
| Rate for Payer: Mclaren Medicaid |
$4,744.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,801.91
|
| Rate for Payer: Meridian Medicaid |
$4,982.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,163.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,310.93
|
| Rate for Payer: Nomi Health Commercial |
$11,876.43
|
| Rate for Payer: PACE Senior Care Partners |
$3,439.82
|
| Rate for Payer: PACE SWMI |
$3,620.86
|
| Rate for Payer: PHP Commercial |
$12,310.93
|
| Rate for Payer: PHP Medicare Advantage |
$3,620.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,744.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,414.24
|
| Rate for Payer: Priority Health HMO/PPO |
$12,600.60
|
| Rate for Payer: Priority Health Medicare |
$3,657.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,703.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,620.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,745.44
|
| Rate for Payer: UHC Core |
$12,093.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,620.86
|
| Rate for Payer: UHC Exchange |
$3,620.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,620.86
|
| Rate for Payer: UHCCP Medicaid |
$4,744.98
|
| Rate for Payer: VA VA |
$3,620.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,862.59
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,483.45
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,414.24 |
| Max. Negotiated Rate |
$13,035.10 |
| Rate for Payer: Aetna Commercial |
$12,310.93
|
| Rate for Payer: BCBS Trust/PPO |
$11,822.84
|
| Rate for Payer: BCN Commercial |
$11,192.81
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cofinity Commercial |
$12,455.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,586.76
|
| Rate for Payer: Healthscope Commercial |
$13,035.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,862.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,310.93
|
| Rate for Payer: Nomi Health Commercial |
$11,876.43
|
| Rate for Payer: PHP Commercial |
$12,310.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,414.24
|
| Rate for Payer: Priority Health HMO/PPO |
$12,600.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,703.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,745.44
|
| Rate for Payer: UHC Core |
$12,093.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,862.59
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$907.80
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.08 |
| Max. Negotiated Rate |
$817.02 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: Aetna Medicare |
$236.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.69
|
| Rate for Payer: BCBS Complete |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$226.95
|
| Rate for Payer: BCBS Trust/PPO |
$746.30
|
| Rate for Payer: BCN Commercial |
$705.81
|
| Rate for Payer: BCN Medicare Advantage |
$226.95
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cofinity Commercial |
$780.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.95
|
| Rate for Payer: Healthscope Commercial |
$817.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.85
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.30
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.63
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: PACE Senior Care Partners |
$215.60
|
| Rate for Payer: PACE SWMI |
$226.95
|
| Rate for Payer: PHP Commercial |
$771.63
|
| Rate for Payer: PHP Medicare Advantage |
$226.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.07
|
| Rate for Payer: Priority Health HMO/PPO |
$789.79
|
| Rate for Payer: Priority Health Medicare |
$229.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.23
|
| Rate for Payer: Railroad Medicare Medicare |
$226.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.86
|
| Rate for Payer: UHC Core |
$758.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.95
|
| Rate for Payer: UHC Exchange |
$226.95
|
| Rate for Payer: UHC Medicare Advantage |
$226.95
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$226.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.85
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$907.80
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$590.07 |
| Max. Negotiated Rate |
$817.02 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: BCBS Trust/PPO |
$741.04
|
| Rate for Payer: BCN Commercial |
$701.55
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cofinity Commercial |
$780.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.24
|
| Rate for Payer: Healthscope Commercial |
$817.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.63
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: PHP Commercial |
$771.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.07
|
| Rate for Payer: Priority Health HMO/PPO |
$789.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.86
|
| Rate for Payer: UHC Core |
$758.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.85
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$772.17 |
| Max. Negotiated Rate |
$2,926.12 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: Aetna Medicare |
$845.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.02
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$812.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.85
|
| Rate for Payer: BCN Commercial |
$2,527.85
|
| Rate for Payer: BCN Medicare Advantage |
$812.81
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,796.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.81
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,438.44
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.45
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.03
|
| Rate for Payer: PACE Senior Care Partners |
$772.17
|
| Rate for Payer: PACE SWMI |
$812.81
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: PHP Medicare Advantage |
$812.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,828.59
|
| Rate for Payer: Priority Health Medicare |
$820.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.34
|
| Rate for Payer: Railroad Medicare Medicare |
$812.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,861.10
|
| Rate for Payer: UHC Core |
$2,714.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.81
|
| Rate for Payer: UHC Exchange |
$812.81
|
| Rate for Payer: UHC Medicare Advantage |
$812.81
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$812.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,438.44
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,113.31 |
| Max. Negotiated Rate |
$2,926.12 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,654.00
|
| Rate for Payer: BCN Commercial |
$2,512.57
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,796.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,438.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.03
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,828.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,861.10
|
| Rate for Payer: UHC Core |
$2,714.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,438.44
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$735.35 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$805.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.57
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$774.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,545.41
|
| Rate for Payer: BCN Commercial |
$2,407.32
|
| Rate for Payer: BCN Medicare Advantage |
$774.06
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.06
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.76
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Senior Care Partners |
$735.35
|
| Rate for Payer: PACE SWMI |
$774.06
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$774.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Medicare |
$781.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: Railroad Medicare Medicare |
$774.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.06
|
| Rate for Payer: UHC Exchange |
$774.06
|
| Rate for Payer: UHC Medicare Advantage |
$774.06
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$774.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.45
|
| Rate for Payer: BCN Commercial |
$2,392.77
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$735.35 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$805.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.57
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$774.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,545.41
|
| Rate for Payer: BCN Commercial |
$2,407.32
|
| Rate for Payer: BCN Medicare Advantage |
$774.06
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.06
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.76
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Senior Care Partners |
$735.35
|
| Rate for Payer: PACE SWMI |
$774.06
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$774.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Medicare |
$781.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: Railroad Medicare Medicare |
$774.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.06
|
| Rate for Payer: UHC Exchange |
$774.06
|
| Rate for Payer: UHC Medicare Advantage |
$774.06
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$774.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.45
|
| Rate for Payer: BCN Commercial |
$2,392.77
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$13.00
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$12.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$13.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$12.38
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$1.65
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$1.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$1.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$1.57
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$966.16 |
| Max. Negotiated Rate |
$4,737.22 |
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: Aetna Medicare |
$1,057.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,271.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,271.26
|
| Rate for Payer: BCBS Complete |
$4,737.22
|
| Rate for Payer: BCBS MAPPO |
$1,017.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,344.34
|
| Rate for Payer: BCN Commercial |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.01
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.01
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,051.03
|
| Rate for Payer: Mclaren Medicaid |
$4,511.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,067.86
|
| Rate for Payer: Meridian Medicaid |
$4,737.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,169.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: Nomi Health Commercial |
$3,335.79
|
| Rate for Payer: PACE Senior Care Partners |
$966.16
|
| Rate for Payer: PACE SWMI |
$1,017.01
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,511.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,539.19
|
| Rate for Payer: Priority Health Medicare |
$1,027.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,725.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,017.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,579.88
|
| Rate for Payer: UHC Core |
$3,396.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,017.01
|
| Rate for Payer: UHC Exchange |
$1,017.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,017.01
|
| Rate for Payer: UHCCP Medicaid |
$4,511.34
|
| Rate for Payer: VA VA |
$1,017.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,051.03
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,644.23 |
| Max. Negotiated Rate |
$3,661.24 |
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,320.74
|
| Rate for Payer: BCN Commercial |
$3,143.78
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,051.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: Nomi Health Commercial |
$3,335.79
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,539.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,725.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,579.88
|
| Rate for Payer: UHC Core |
$3,396.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,051.03
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$304.91 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: BCBS Trust/PPO |
$382.92
|
| Rate for Payer: BCN Commercial |
$362.51
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: Nomi Health Commercial |
$384.65
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health HMO/PPO |
$408.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.80
|
| Rate for Payer: UHC Core |
$391.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.82
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$111.41 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: Aetna Medicare |
$121.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.59
|
| Rate for Payer: BCBS Complete |
$187.64
|
| Rate for Payer: BCBS MAPPO |
$117.27
|
| Rate for Payer: BCBS Trust/PPO |
$385.64
|
| Rate for Payer: BCN Commercial |
$364.72
|
| Rate for Payer: BCN Medicare Advantage |
$117.27
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: Nomi Health Commercial |
$384.65
|
| Rate for Payer: PACE Senior Care Partners |
$111.41
|
| Rate for Payer: PACE SWMI |
$117.27
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: PHP Medicare Advantage |
$117.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health HMO/PPO |
$408.11
|
| Rate for Payer: Priority Health Medicare |
$118.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.29
|
| Rate for Payer: Railroad Medicare Medicare |
$117.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.80
|
| Rate for Payer: UHC Core |
$391.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.27
|
| Rate for Payer: UHC Exchange |
$117.27
|
| Rate for Payer: UHC Medicare Advantage |
$117.27
|
| Rate for Payer: VA VA |
$117.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.82
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,206.15 |
| Max. Negotiated Rate |
$1,670.06 |
| Rate for Payer: Aetna Commercial |
$1,577.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,514.74
|
| Rate for Payer: BCN Commercial |
$1,434.02
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,595.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,670.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,391.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: Nomi Health Commercial |
$1,521.61
|
| Rate for Payer: PHP Commercial |
$1,577.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,614.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,243.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,632.95
|
| Rate for Payer: UHC Core |
$1,549.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,391.71
|
|
